TY - JOUR T1 - A nudge towards better lumbar puncture practice JF - Clinical Medicine JO - Clin Med SP - 477 LP - 479 DO - 10.7861/clinmed.2020-0201 VL - 20 IS - 5 AU - Christian Holland AU - Evan C Edmond AU - Catherine Moore AU - Vanessa Tobert AU - Johannes C Klein AU - Martin R Turner Y1 - 2020/09/01 UR - http://www.rcpjournals.org/content/20/5/477.abstract N2 - Background Despite a body of evidence demonstrating reduced incidence of post-lumbar puncture headache associated with pencil-point (vs bevelled-edge) needles, their use remains variable in the UK.Methods A multimodal longitudinal intervention was performed over a 12-month period at a tertiary neurology referral centre. In addition to simulation training using pencil-point needles and an electronic documentation pro forma, a change in the default needles presented in clinical environments was performed.Results Prior to the intervention, pencil-point needle usage was minimal. Documentation significantly improved throughout the intervention period. Simulation training interventions only resulted in transient, moderate improvements in pencil-point needle usage. However, changing the default produced a marked increase in use that was sustained. No significant changes in operator success rate were found.Conclusions In the context of wider literature on the power of default options in driving behavioural choices, changing defaults may be an effective, inexpensive and acceptable intervention to improve lumbar puncture practice. ER -